Background: Stress is a fact of life that every human deals with on a daily basis. In the transitional nature of student life in professional courses like nursing, initial period of course is stressful and it adversely affects the emotional, physical, social, and academic functions. Even though the perception and response to stress and way of coping differs individually, it may produce questionable behavioral patterns in student nurses during the course of their study like feeling of loneliness, nervousness, sleeplessness, and worrying. Thus, the student nurse faces a lot of challenges and problems at the time of I Year. Objectives: The present study aimed to determine the level of stress and coping mechanisms adopted by I Year B.Sc. nursing students. Materials and Methods: A total of 60 I Year B.Sc. nursing students were selected by using non-probability convenient sampling technique. The tools used for data collection were perceived stress scale, structured coping scale, and socio- demographic proforma. Results: The studies revealed that majority of students (95.1%) were in the age group of 17-19 years. The results showed that only one student (1.7%) has severe stress, 46.7% has moderate stress, and remaining 51.6% has mild stress, and majority of the students (100) had average coping. There was no significant correlation (-1.167) between stress and coping mechanism of I Year B.Sc. nursing students. Conclusion: Majority of students had mild stress and average coping. The nurse administrator should plan and organize educational program for nursing students, in order to prepare them to cope up with any stressful situations. Hence, the researcher emphasizes the need for more research to improve the knowledge and by applying the research finding for future.

Low birth weight (LBW) is a significant public health concern at global level. LBW is the outcome of interplay of multiple maternal factors. Maternal age is an important variable leading to LBW and preterm births. The literature review was done with extensive search from Medline, the Educational Resources Information Center, and the Combined Health Information Database for publications that identified the studies related to maternal age and birth weight. With exception of few studies which concluded that age did not significantly affect birth weight of newborns, majority of research indicated that a very young maternal age is causally implicated with an increased risk of having LBW and preterm births. Little research has been conducted on births to older mothers, even though such births are becoming increasingly common in developed countries. Advancing maternal age is associated with a decreased potential for fetal growth, possibly reflecting biological aging of maternal tissues and systems or the cumulative effects of disease. Results of multivariate analysis showed a U-shaped relationship between maternal age and LBW among whites, with the youngest (younger than 15) and the oldest (aged 40 and older) mothers being at high risk than 25-29 years old; older teenagers were not at any significantly higher risk. For the black, the risk of LBW rose steeply with maternal age (mothers aged 15-19 years are significantly lower risk than those of 25-29 years for LBW infants).

Surgical care has become highly specialized because of scientific advances. It is now possible to handle many health problems successfully with the help of newer and innovative methods. However, to deliver care safely to patients as well as prevent harm to the personnel delivering the same, safe practices have to be followed. In developing nations especially, as modern surgical care percolates the masses, ignoring safe surgical practice may cause more harm than good and the surgeon / procedure may even earn disrepute. This article reviews different aspects of current surgical practice with respect to safe surgical care and asepsis.

An 18-year-old male presented with history and clinical findings suggestive of penile fracture. An MRI demonstrated disruption of the tunica albuginea and corpora cavernosa on the left dorso-lateral aspect, mid-shaft of penis with adjacent hematoma, and subcutaneous edema. At surgery, imaging findings were found to be accurate, and the penis was successfully repaired with minimal postoperative morbidity.

Magnets have generated great interest within dentistry. They have been used for various applications in orthodontics and prosthodontics. Earlier use of magnets was limited due to the unavailability of small size magnets, but after the introduction of rare earth magnets and their availability in smaller sizes, their use has increased considerably. They can be placed within prostheses without being obtrusive in the mouth. Their main use in orthodontics has been for tooth movement and in prosthodontics has been in maxillofacial prosthesis and in overdentures as retentive aids. This article reviews the types of magnets available and their application in maxillofacial prosthesis and overdentures, followed by other advantages and disadvantages.

Ectopic eruption of teeth in non-dental sites is a rare phenomenon and such cases have been reported to occur in the nasal cavity, chin, maxillary sinus, mandible, palate, and orbital cavity. Ectopic tooth eruptions in maxillary sinus are usually asymptomatic or may present with recurrent sinusitis. Majority are found incidentally during routine clinical or radiological investigation. We present a case of an ectopic upper second premolar tooth that caused chronic purulent sinusitis in relation to the right maxillary sinus. The tooth was attached to the posterior wall of the sinus without an associated dentigerous cyst. The case was innovatively managed by endoscopic approach through sublabial route.

Background: Strabismus is one of the causes for visual impairment in childhood. It affects the development of binocular single vision. Therefore, early detection and timely management of strabismus is important. Aim: This study was aimed to describe types of strabismus patients presenting to a tertiary care center and the various management modalities including the surgical outcomes of ocular re-alignment Materials and Methods: Retrospective chart analysis of all patients with strabismus in any age group over a period of 5 years. Patients with cerebral palsy were excluded from this study. Surgical outcomes were graded as good if the eyes were orthophoric post-operatively, satisfactory if there was a residual squint of less than 10 degrees, and it was considered to be a poor outcome if the patients were left with more than 10 degrees of residual squint. Results: Chart analysis of 53 cases with strabismus comprising of 33 males and 20 females was done. The mean age of patients was 25 years. Thirty-two (60%) cases had exotropia, and 14 (26%) had esotropia. Three cases were of congenital superior oblique palsy, and one case was of lateral rectus palsy. Duane syndrome type I was seen in four cases. Of the 38 (72%) patients who were advised surgical correction, only 20 individuals underwent surgery. Reasons for refusal of surgery varied from fear factor to financial constraints and a disregard for cosmesis. Surgeries had been performed on both children (7) as well as adults (13). Seventy-five percent of the operated patients had exotropia. Eighteen patients underwent single-staged surgery. Bilateral recessions were the most common type of surgery noted in this study. Fifty percent of them remained orthophoric up to one year of post-operative follow up. Conclusion: Exotropia was the most common type of strabismus observed in this study. Successful ocular re-alignment was seen in majority of the patients following a single-stage procedure. Greater effort needs to be made to educate the public on need for early diagnosis and management.

Background : Human papilloma virus (particularly HPV 6 and 11) has been documented in 20% to 76% of nasopharyngeal papillomas. HPV is also associated with 25% keratinizing nasopharyngeal squamous cell carcinoma detected by studies using techniques of immunopathology and by modern molecular biology. Objectives: To study the role of human papilloma virus as an etiological agent in sinonasal papillomas and nasopharyngeal carcinomas (NPCs) by immunohistochemistry (IHC). Materials and Methods: A total of 26 cases of neoplasms were studied for HPV antigen. Tumors were classified histopathologically by using Hematoxylin and Eosin-stained slides. Evidence of HPV infection like koilocytic changes and HPV antigens were noted down in all 26 cases. Results: There were 14 sinonasal papillomas, 7 each of fungiform and inverted types and 12 nasopharyngeal carcinomas. All cases of fungiform papillomas had either histological (koilocytes) or immunohisochemical evidence of HPV infection. 85.5% of inverted papillomas had evidence of HPV infection either in the form of koilocytes or in the form of positive immunohistochemistry or both. 50% of nasopharyngeal carcinomas had histological and immunohistochemical (either one or both) evidence of HPV infection. Conclusion: This study, unlike other studies, has found higher rate of HPV detection in both types of Schneiderian papillomas. Not many studies have been carried out on nasopharyngeal carcinomas. We have found evidence of HPV infection in 100% of moderately differentiated squamous cell carcinomas and 33.3% cases of poorly to undifferentiated cases of NPC.

Accidents could occur at home in any age group. Accidental ligature strangulation in adults could be prevented. We are reporting a case of a woman who died in her kitchen due to accidental strangulation by her dupatta while working with the electric grinder. This case highlights the need to educate the people about the safety and potential hazards of these machines.

Impacted molars have been widely reported. However, kissing molars is a rare finding which refers to impacted molars which have occlusal surfaces contacting each other in a single follicular space and roots pointing in opposite directions as reported in this case. This is the second case of kissing molars involving third and fourth molar and the only case fulfilling the criteria of kissing molars.

India has not been able to achieve the target of "Health for All" so far. The burden of diseases in India still remains large. There is a wide gap between the requirements and availability of doctors especially in rural and outreach areas. Even the available doctors do not have the clinical competencies or mental make up to meet the healthcare requirements of the village population in India. Hence an overhauling of medical education has become inevitable at this point of time. Significant curricular changes reducing the theory component to the minimum and transaction of the curricular content through electronic learning mode with horizontal and vertical integration of pre-clinical, para clinical and clinical subjects assigning more time for clinical teaching will bring up a new generation of clinicians of first contact with the required clinical competencies and right attitude.

Introduction: Hypospadias is one of the most common congenital anomalies of male external genitalia. It occurs in approximately 1 in 250 newborn. Hypospadias can be defined as an abnormal urethral orifice under surface of the penis with or without chordee and with or without dorsal hood. Hypospadias may be an isolated defect or a phenotypical component of a more complex condition such as an intersex state. The only treatment is surgery. Thus, prevention is imperative. To accomplish this, it is necessary to determine the etiology of hypospadias. Objective: To identify risk factors for hypospadias, with a focus on potential endocrine disruption, in parental demography, diet, and occupation. Materials and Methods: In a case-control study nested within a cohort of 3246 male births, we compared 17 hypospadias cases with 68 controls. Through questionnaire proforma, information was collected on pregnancy aspects and personal characteristics. Result: Our findings indicate that parental pesticide exposure and smoking were associated with hypospadias, maternal occupational exposure, diet and life style were not associated with hypospadias. The prevalence rate of hypospadias in our study was 0.05%. Conclusion: Since the paternal pesticide exposure and smoking were significantly associated with hypospadias, paternal exposure should be included in further studies on hypospadias risk factors.

There has been much debate on duration of orthodontic treatment. Recent clinical trials have attempted to reduce the same. The purpose of this study was to compare the treatment duration of class I, class II, and class III malocclusions. Thirty patients were selected and divided into 3 groups of 10 each according to the malocclusion present, and the treatment time was determined and compared. The mean treatment duration for orthodontic therapy is 19.7 months with least time taken for class III malocclusions followed by class I and maximum time taken for class II malocclusion.

Introduction: E-learning includes various categories of media that distribute text, audio, images, animation, and streaming video, and includes technology applications and processes, computer-based learning, as well as local intranet/extranet learning. Information and communication systems motivate many e-learning processes. E-learning can occur in or out of the classroom. ILIAS (Integriertes Lern-, Informations- und Arbeitskooperations-System [German for "Integrated Learning, Information and Work Cooperation System"]) is an open source web-based learning management system (LMS). It supports learning content management and tools for collaboration, communication, evaluation, and assessment for University students. Materials and Methods: First year medical students were requested to register in Yengage, and the date of the assessment was announced. Twenty MCQ from cardiovascular system was preloaded in the Yengage portal, and the students used their personal laptop to answer the questions within the stipulated time. The results were automatically loaded at the end of the assessment. Pre- and post-test was conducted to investigate the usefulness of the E- assessment. Results: The students responded that the E-assessment was easy to assess, unique as they received immediate feedback, customized and flexible. There was significant difference in the post-test score when compared to the pre-test score. Discussion: Technology has created new methods of assessment for today's generation of students, and these advances are here to stay. Conclusion: It is possible to conduct online examinations in medical school regularly. The e-learning can enhance student interests and allows immediate feedback. Since e-learning is not well-established in India, we hope to create awareness and change the outlook of medical students in online teaching-learning and assessment program.

Background: Obesity is the culmination of a chronic imbalance between energy intake and energy expenditure. This energy balance can be potentially affected by the activity of autonomic nervous system (ANS). Altered sympathetic nerve function may be of importance in obesity. Objective: The present study is an attempt to pinpoint the defect (if any) in the activity of sympathetic limb of the ANS in obesity, by subjecting to isometric exercise stress. Materials and Methods: A total of 81 females belonging to the age group of 18-22 years were recruited for the study. The participants were divided into two groups as normal weight and obese based on WHO guidelines for Asia Pacific region. After recording the resting blood pressure, they were subjected to isometric exercise by Handgrip dynamometer. Blood pressure was recorded again, and the difference was noted down. All recorded parameters were compared between two groups using unpaired t test. The relationship between body mass index (BMI) and rise in diastolic pressure was quantified by Pearson's correlation test. A P value less than 0.05 was considered as significant. Results: In obese, the diastolic pressure was significantly higher at rest, but showed reduced rise during handgrip test in comparison with normal weight individuals. Also, the rise in diastolic pressure exhibited a negative relation with BMI. Conclusion: The result is suggestive of impaired autonomic function at rest and reduced sympathetic activity in the group of obese when subjected to stress. This could make them more prone for future development of hypertension or other cardiovascular disorders.

A 25 year old male presented with swellings around the left elbow and forearm since 2 years. Examination showed 4 swellings along the course of median nerve over the left arm, elbow and forearm. They were circumscribed, soft to firm nodules with tenderness. There were no cutaneous lesions suggesting of leprosy. Histopathological examination of a biopsy from a swelling showed granulomas in the epineurium suggesting the diagnosis of leprosy neuritis. With these clinico-pathological features diagnosis of median nerve abscesses was confirmed. The patient was treated with multi drug therapy for leprosy and oral steroids.

Use of qualitative analysis to supplement program evaluation of a faculty development programThomas V ChackoJanuary-June 2013, 1(1):67-72DOI:10.4103/2321-4848.113581

Introduction: Generally for Program Evaluation of workshops, a structured questionnaire is used to measure learner satisfaction and learning and it yields results in quantitative terms and if there are open-ended questions, it yields a long list of responses which the evaluator finds it difficult to use. Hence, we used qualitative research methods to supplement it for a holistic understanding of the quality and extent of their learning. Materials and Methods: A faculty development program was used opportunistically to gather data using open-ended questions designed to elicit "thick descriptions" about their learning. Using the Grounded Theory approach where the data drives further analysis, data analysis was done by faculty in three groups using inductive reasoning leading to emergence of themes and categories of responses. The commonalities in the themes that emerged independently in the three groups as well as member checking to seek their agreement with the group's observation of the primary data were used to ensure validity of the findings. Results: Themes and categories of new learning in terms of knowledge, skills, attitudes and processes emerged which gives a better understanding of the extent of the learning and its applicability to future professional tasks. The open-ended questions encouraging participants to give "thick description" of their learning yielded many quotable quotes which indicate the quality of their learning. Conclusion: The use of open-ended questions and qualitative research method of data analysis using the Grounded Theory approach helps in holistic understanding of the focus and quality of learning that is not usually possible through quantitative research methods. Hence, it is recommended that when understanding of the extent and quality of learning is important, traditional method of program evaluation should be supplemented with qualitative research methods as they are more effective in convincing decision makers.